EOB denial code PR-3: what it means

What it means

This is your copay — a fixed dollar amount you owe for this type of visit or service (for example, a set fee per office visit).

Patient Responsibility — an amount the patient owes, such as a deductible, copay, coinsurance, or non-covered service.

Official X12 description

“Co-payment Amount”

Typical cause

The plan applied the flat copay defined for this service category. This is normal cost-sharing, not a denial.

What to do next

1. 1Confirm the copay amount matches your plan's Summary of Benefits and Coverage for this service.
2. 2If you already paid the copay at the visit, make sure you are not billed twice.